General practitioners' views of pharmacist services in general practice: a qualitative evidence synthesis

Lay Summary This review presents the evidence, for the first time, on general practitioners' (GPs') views of pharmacist services in the general practice setting worldwide. Pharmacist services in general practice have the potential to yield several benefits for the practice, patient, and GPs themselves. However, to include pharmacist services in the practice is a complex process; this review gives an insight into GPs' thoughts on the matter, what works-and if so, why-and what does not work. This review will therefore prove useful to GPs, pharmacists, practice managers, policymakers, and academics wishing to establish or improve pharmacist services in the general practice environment. Background Pharmacist services in general practice are expanding worldwide, with evidence to show pharmacists' presence in general practice has financial, workload, and clinical benefits. Yet, little is known globally about general practitioners' (GPs') views on their presence in general practice. Objective To synthesize the qualitative research evidence on GPs' views of pharmacist services in general practice. Methods Qualitative evidence synthesis; 8 electronic databases were searched from inception to April 2021 for qualitative studies that reported the views of GPs regarding pharmacist services in general practice. Data from included studies were analyzed using thematic synthesis. The Confidence in the Evidence from Reviews of Qualitative research (CERQual) approach was used to assess the confidence in individual review findings. Results Nineteen studies were included, which captured the views of 159 GPs from 8 different countries. Four analytical themes describing the factors that should be considered in the development or optimization of pharmacist services in general practice, based on the views of GPs, were developed from the coded data and descriptive themes: (i) optimal environment for a pharmacist, (ii) the ideal pharmacist characteristics, (iii) complex stakeholder relationships, and (iv) benefits of an effective pharmacist. Conclusion Based on the synthesis of GPs' views, we have created a conceptual model of factors that should be considered by policymakers, GPs, pharmacists, and other relevant stakeholders when developing or optimizing pharmacist services in general practice going forward.